CN102973314A - Thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system and application - Google Patents
Thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system and application Download PDFInfo
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- CN102973314A CN102973314A CN2011102633876A CN201110263387A CN102973314A CN 102973314 A CN102973314 A CN 102973314A CN 2011102633876 A CN2011102633876 A CN 2011102633876A CN 201110263387 A CN201110263387 A CN 201110263387A CN 102973314 A CN102973314 A CN 102973314A
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Abstract
The invention relates to a thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system and application. The thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system is composed of minimally invasive bone cement spine internal fixation system implantation materials and relative surgical instruments. The minimally invasive bone cement spine internal fixation system implantation materials comprise vertebral pedicle bolts, a neck-bending connection bar and jackscrews. The relative surgical instruments comprise implantation and orthopedic tools and the implantation materials are corresponding to the implantation and orthopedic tools. Excepting universal surgical tools, the relative surgical instruments specially comprise special tools directing at minimally invasive surgery percutaneous surgery and bone cement injection. The thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system and application has the advantages that fixed advantages of the minimally invasive surgery and bone cement injection are combined, system trauma is small, an anti-pullout force is strengthened due to the bone cement injection, complications such as unstable spine, looseness, relapse can be avoided, and the thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system is particularly suitable for agedness osteoporosis patients.
Description
[technical field]
The present invention relates to the spinal surgery technical field of medical instruments, specifically, is a kind of thoracic and lumbar vertebral posterior Wicresoft's bone cement spinal internal fixation system and application.
[background technology]
Common thoracolumbar spine disease comprises degeneration, fracture, tumor, infection etc., and spinal operation and interior fixation application have been made significant headway from the material to the design in the history of clinical existing last 100 years.Traditional internal fixation of spine operation wound is larger, and soft tissue cuts and peels off widely, causes easily hemorrhage morely, and the dissect physiology of spinal column changes and vertebral body is unstable, the complication such as postoperative rehabilitation time lengthening.The minimally invasive spine surgical operation is since the development seventies in last century, and the orthopedist progressively recognizes necessity and the importance of minimally invasive spine surgical at present, and will become the developing direction of spinal surgery.
Along with the progress of spinal surgery new technique, bone cement materialogy, biomechanics Research, bone cement is widely used in field of spinal surgery.At present, the application of bone cement in spinal surgery is mainly in the following aspects: 1, percutaneous balloon kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) are treated pathologic vertebral compression fracture and the intractable pain that osteoporosis, Vertebral Hemangioma, myeloma etc. cause; 2, tumor of spine row vertebral resection postoperative is as the embedded material of carrying spinal column; 3, serve as pharmaceutical carrier; 4, reinforce spine pedicle screws nail road.Bone cement is injected vertebral body, can strengthen the Rigidity and strength of vertebral body, rebuild the stability of spinal column, reach alleviating pain, correct kyphosis deformity, improve the purpose of quality of life of patients.This is particularly effective for sufferers of osteoporosis face.
Report according to Chinese Medical Association: China has entered the aging society stage, and the spinal column disease incidence surpasses 30% in the domestic over-65s aging population.The tradition open surgery, larger for patient's wound, old age or systemic conditions relatively poor patient can not undergo surgery, and the operative rehabilitation time is longer, and causes easily the complication such as postoperative unstable spine, interior fixing loosening, postoperative recurrence.Particularly old people with osteoporosis becomes flexible owing to its sclerotin reason more is prone to interior fixing.
Therefore, along with the development of material and medical skill, provide a kind of minimally invasive spine internal fixation system that injects in conjunction with bone cement, for the treatment of old people with osteoporosis spinal disease very important function and significance is arranged.Wherein the pain of Minimally Invasive Surgery mode energy reduction of patient is damaged little; Simultaneously bone cement injection can increase the resistance to plucking of screw exerts oneself, and strengthens the strength and stiffness of vertebral body.
[summary of the invention]
The object of the invention is to overcome the deficiencies in the prior art, a kind of thoracic and lumbar vertebral posterior Wicresoft's bone cement spinal internal fixation system and application are provided; This internal fixation system combines Minimally Invasive Surgery and the fixing advantage of bone cement, when realizing Minimally Invasive Surgery, inject bone cement by hollow pedicle screw, the resistance to plucking that strengthens screw is exerted oneself, system trauma is little, simultaneously can avoid occuring the complication such as unstable spine, loosening, recurrence, be specially adapted to old people with osteoporosis.
The objective of the invention is to be achieved through the following technical solutions:
A kind of thoracic and lumbar vertebral posterior Wicresoft bone cement spinal internal fixation system is comprised of Wicresoft's bone cement spinal internal fixation system implant and corresponding operating theater instruments;
Described Wicresoft bone cement spinal internal fixation system implant comprises pedicle screw, pre-bending pitman and jackscrew;
Described pedicle screw is hollow design, simultaneously side, the place ahead perforate or groove, and hole or groove quantity can be for a plurality of, and the size of side perforate or groove is less close to more from the bone cement injection end; Screw adopts special-purpose injection tool to inject in implantation afterwards, and the bone cement of injection passes pedicle of vertebral arch by the mesopore of pedicle screw, enters vertebral body from pedicle screw the place ahead side opening or groove, increases resistance to plucking and exerts oneself;
Described pre-bending pitman is curved, and an end is tapered to be dwindled gradually, so that percutaneous is implanted, the other end is provided with and the groove of holding excellent device coupling;
The described jackscrew outside is provided with screw thread, and an end is provided with interior plum blossom hole, and the other end is provided with pointed projections, and for the single step locking device or be two step locking devices, it is used for locking rod, after rod is put into, thereby is screwed into locking rod;
Described corresponding operating theater instruments comprises implantation and the orthopedic tool of hollow pedicle screw and pre-bending pitman, except general operation tool, particularly including the specific purpose tool for micro-wound percutaneous operation and bone cement injection; Such as puncture needle, the puncture needle sleeve pipe, the tip guide pin, spherical guide pin, hollow gag, dilator, hollow boring bit, hollow screw tap, opening screw stretcher, the screw stretcher of remaining silent, the screw mounting seat, the screw mounting guide sleeve, opening screw stretcher sleeve pipe, the stretcher locking wrench, follow closely device on the hollow, bone cement injector, the rod measuring device, hold excellent device, the rod locker, the push rod device, the fascia separator, plug screw is held and is got device, prelum, crow bar, antitorque spanner, final impact wrench etc.
Implant of the present invention and instrument are fully supporting; Gag, open circuit device, screw tap, pedicle screw, upper nail device are hollow design, and the diameter of hollow is identical with guide pin.
The specially designed hollow Universal-head of the present invention pedicle screw, screw stretcher and hold excellent device, after this cover apparatus can be guaranteed pedicle screw, the pitman percutaneous inserted the ailhead of screw, and pressurizes through screw stretcher sleeve pipe.
The present invention adopts the good pitman of pre-bending, has stronger biomechanical stability, and is less to little joint injury, and soft tissue is peeled off still less, can lower to greatest extent the damage to muscle of back, ligament and fascia.
Implant pedicle screw of the present invention and pre-bending pitman have different specification size, choose according to actual needs use in the art.
Compared with prior art, good effect of the present invention is:
A kind of thoracic and lumbar vertebral posterior Wicresoft bone cement spinal internal fixation system, combine the fixing advantage of Minimally Invasive Surgery and bone cement injection, system trauma is little, the injection of bone cement strengthens the resistance to plucking of screw and exerts oneself, can avoid occuring the complication such as unstable spine, loosening, recurrence, be specially adapted to old people with osteoporosis.
[description of drawings]
Fig. 1 hollow pedicle screw sketch map of the present invention;
Fig. 2 pre-bending pitman of the present invention sketch map;
Fig. 3 jackscrew sketch map of the present invention;
Fig. 4 screw stretcher of the present invention sketch map.
Fig. 5 operation technique of the present invention---screw and stretcher assembling sketch map 1
Fig. 6 operation technique of the present invention---screw and stretcher assembling sketch map 2
Fig. 7 operation technique of the present invention---screw is screwed into sketch map
Fig. 8 operation technique of the present invention---bone cement injection sketch map
Fig. 9 operation technique of the present invention---rod with hold excellent device connection diagram
Figure 10 operation technique of the present invention---put excellent sketch map
Figure 11 operation technique of the present invention---push rod sketch map
Figure 12 operation technique of the present invention---jackscrew is screwed into sketch map
Figure 13 operation technique of the present invention---remove and hold excellent device sketch map
Figure 14 operation technique of the present invention---the antagonism spanner is finally locked sketch map
Figure 15 operation technique of the present invention---remove screw stretcher sketch map
Reference numeral explanation: 1, pedicle screw, 11, screw cap, 12, packing washer, 13, rivet nut, 111, female thread, 112, U-shaped deep trouth, 113, groove, 114, spherical mortar cup, 115, inverted draw cut, 121, projection, 122, U-shaped groove, 123, spherical mortar cup, 131, hollow hole, 132, the side fluting, 133, the side fluting, 134, the side perforate, 135, screw thread, 136, bulb, 137, inner hexagonal hole, 2, jackscrew, 21, the locking plug screw, 22, the pressure bar screw, 211, external screw thread, 212, female thread, 213, cross recess, 221, external screw thread, 222, interior plum blossom hole, 223, the top tip, 3, the pre-bending pitman, 31, the tapered reduction end, 32, groove, 33, arcuation, 41, opening screw stretcher, 42, the screw stretcher of remaining silent, 43, screw extends assembler, 44,, screw is to wire guider, and 45, the slotted nut locker, 46, screw stretcher sleeve, 47, follow closely device on the hollow, 471, follow closely handle on the hollow, 472, bar in the upper nail device, 473, upper nail device overcoat, 48, the rod locker, 49, hold excellent device, 50, the push rod device, 51, tampon holder, 52, antitorque spanner, 53, guide pin, 54, bone cement injector.
[specific embodiment]
The specific embodiment of a kind of thoracic and lumbar vertebral posterior of the present invention Wicresoft's bone cement spinal internal fixation system and application below is provided.
Fig. 1,2,3 is the implant sketch map.Wherein Fig. 1 is the hollow pedicle screw sketch map, and Fig. 2 is the jackscrew sketch map, and Fig. 3 is pre-bending pitman sketch map.
As shown in Figure 1, hollow pedicle screw 1 is made of three parts, screw cap 11, packing washer 12 and rivet nut 13.Screw cap 11 is provided with U-shaped deep trouth 112; Inside is provided with female thread 111; Inwall is provided with groove 113, in order to spacing to packing washer; Inside is provided with spherical mortar cup 114, in order to cooperate with the rivet nut head; Afterbody is provided with inverted draw cut 115, in order to lock with screw stretcher coupling.Packing washer 12 is provided with U-shaped groove 122; Both sides of the edge are provided with projection 121, cooperate in order to spacing with the groove 113 of screw cap; Packing washer 12 lower ends are provided with spherical mortar cup 123.Rivet nut 13 is hollow design 131; Side perforate or groove 132,133,134, along with from bone cement Injection Section distance more close to perforate less, perforate size 132＞133＞134; Rivet nut is provided with screw thread 135; Rivet nut 13 heads are spheroid 136; The rivet nut end is provided with inner hexagonal hole 137.
As shown in Figure 2, jackscrew 2 is two locking devices, is made of locking plug screw 21 and pressure bar screw 22 two parts.Locking plug screw 21 is provided with external screw thread 211, female thread 212 and cross recess 213.Pressure bar screw 22 is provided with external screw thread 221, interior plum blossom hole 222 and top tip 223.
As shown in Figure 3, pre-bending pitman 3 one ends are tapered to dwindle 31 gradually, so that percutaneous is implanted; The other end is provided with and the groove 32 of holding excellent device device coupling; Excellent curved shape 33 of while.
Fig. 4-15 is instrument and operation technique sketch map.Below in conjunction with accompanying drawing operation technique is further specified.
1. set up service aisle.
Longitudinal cut cuts skin and fascia, inserts puncture needle.Use normotopia and side position perspective, biopsy needle guide enters the entry point between little joint and transverse process.Confirm that the guide pin syringe needle is positioned at the outer rim of pedicle of vertebral arch on the positive bit slice.After be screwed into puncture needle until the center of pedicle of vertebral arch, and guarantee that by normotopia, side position perspective guide pin do not wear out pedicle wall.Remove the puncture needle inner core.
2. placement guide pin
The screw thread guide pin is inserted the puncture needle sleeve pipe.After extract the puncture needle sleeve pipe.
3. pedicle of vertebral arch is prepared
When preparing the pedicle of vertebral arch tapping, first with dilator intramedullary expansion jacket casing outside guide pin and insert surface of bone.Use perspective to confirm.At the upper outside expansion sleeve of intramedullary expansion bush outer sleeve, and intactly be placed on the entry point.After guide pin and outer expansion sleeve lock are fixed, remove the intramedullary expansion sleeve.
Insert hollow boring bit in the cortical bone place enlarging of pedicle of vertebral arch entry point along guide pin.The hollow of suitable dimension is enclosed within the guide pin place and is screwed into pedicle of vertebral arch from boring screw tap, during tapping, notice checking that sounding mark on the guide pin and vertical marker excessively are screwed into and rotate avoiding, and do not attack to guide pin.The sounding mark on the screw tap simultaneously can be used for determining the length of screw.Remove screw tap, use the talent scout to confirm that in guide pin is other pedicle of vertebral arch is complete.
4. the assembling of screw and screw stretcher
Such as Fig. 4, for the operation of single segmental percutaneous, an opening screw of recommendation stretcher 41 and the screw stretcher 42 of remaining silent.For guaranteeing exact connect ion, screw 1 should use extension assembler 43 and screw that wire guider 44 is assisted, such as Fig. 5.Select suitable screw to extend assembler according to the sounding mark on the outer expansion sleeve.The required suitable screw screw of packing into is extended in the assembler 43, connect wire guider 44 at the assembler top again.
Such as Fig. 6 A, will keep the direction of opening stretcher to the etching line on the fluting on the wire guider 44 and the opening screw stretcher 41 alignment, with it along wire guider is down inserted, until touch the screw afterbody.With screw stretcher 90-degree rotation,, hear that the sound of " click " represents that screw is hunted down such as Fig. 6 B.Use slotted nut locker 45 lock screw 1 and screw stretcher 41, such as Fig. 6 C.Remove and extend assembler 43 and guider 44, check that screw and stretcher stable connection are correct, such as Fig. 6 D.Behind the stable connection, screw stretcher sleeve 46 is inserted opening screw stretcher 41 to confirm safety, such as Fig. 6 E.
At opening screw stretcher 41 interior insertion hollow nail devices 47, such as Fig. 7, bar 472 anterior hexagon end heads cooperate with the inner hexagonal hole of rivet nut 13 in the upper nail device, and upper nail device overcoat 473 anterior external screw threads are screwed into the head of a nail 11, so far nail device 47 and screw 1 stable connection on the hollow.
Slotted nut locker 45 repeats the same step for closure screws stretcher 42, except will insert the closure screws stretcher.
5. be screwed into pedicle screw and inject bone cement
Such as Fig. 7, first screw load module is inserted pedicle of vertebral arch along guide pin, be screwed into pedicle screw 1.Guide pin 53 can remove after screw is screwed into pedicle of vertebral arch.Recommendation has an X-rayed to guarantee that screw position is suitable when being screwed into screw.
Remove nail device handle 471 on the hollow, bone cement injector 54 is connected with bar 472 in the upper nail device, such as Fig. 8.Inject bone cement at hollow pedicle screw 1.The bone cement that injects passes pedicle of vertebral arch by the mesopore 131 of pedicle screw, enters vertebral body from side opening or the groove of pedicle screw 1.The slowly injection of control bone cement during the Cement injection device.
After injection is finished, first upper nail device overcoat 473 reverse rotations are separated with screw, then remove nail device 47 on the hollow.
Repeat above step, at all sections pedicle screws.Remove the outer stretcher sleeve 46 of opening screw stretcher.
Rod with hold excellent device and be connected
Use excellent measuring device, determine the pre-curved rod of appropriate size.Excellent locker 48 inserted holds excellent device 49 until the contact, and with its locking until rod 3 hold tight, such as Fig. 9.Remove excellent locker 48 and confirm that rod has connected accurately.
7. put rod
For the operation of single segmental percutaneous, its step is as follows:
(1). with screw stretcher 41,42 register, the rotation screw stretcher 42 of remaining silent is aimed at opening screw stretcher 41.
(2). slowly rod 3 is down straightened to it along the screw stretcher 42 of remaining silent and touch screw 1 afterbody or until surrounding tissue can allow the deep-seated of its arrival to put, such as Figure 10 A
(3). will hold excellent device 49 90-degree rotations
(4). the handle that will hold excellent device 49 is inserted the far-end of the screw stretcher 42 of remaining silent, such as Figure 10 C.
(5). at opening screw stretcher 41 overcoat screwing stretcher sleeves 46, again push rod device 50 is inserted opening screw stretcher 41, such as Figure 11.Fluoroscopy during operation is confirmed the position of rod.For guaranteeing excellent correct position, when push rod device 50 is in opening screw stretcher, mentions and hold excellent device 49.If hold excellent device also with on carry, illustrate that then rod has boosted the push rod device, prove the rod in the screw afterbody.
8. jackscrew is screwed into.
Get one piece of jackscrew to tampon holder 51, the projection of handles distal after inserting is until jackscrew is stable.After the guiding tampon holder enters opening screw stretcher 41, slowly lock jackscrew with locking rod 3, such as Figure 12.
9. remove and hold excellent device.
Before removing, confirm that by X-ray in the art far-end of rod is positioned at the screw afterbody and rod exposes each screw afterbody 5mm first.Such as Figure 13, insert excellent locker 48 to holding excellent device 49.Reverse rotation, with rod 3 with hold excellent device 49 disengagings.Remove excellent locker 48 and screw stretcher sleeve 46.Repeating above step is screwed into jackscrew in the screw stretcher 42 of remaining silent.
10. pressurization
Place screw stretcher lateral skin surface direction to slide prelum.T-shaped handle is placed the prelum top, and it is inboard to be positioned at 2 screw stretchers.Insert final impact wrench in closure screws stretcher IT jackscrew.Pressurization, and locking jackscrew.Strutting operation can realize by T-shaped handle being placed the prelum below and being positioned at 2 screw stretcher inboards.
11. final locking
12. remove the screw stretcher
The screw stretcher sleeve pipe 46 that opening screw stretcher is outer removes.Use slotted nut locker 45 to separate opening screw stretcher.4190 ° of rotary screw stretchers also remove.Repeat identical step for closure screws stretcher 42, such as Figure 15.
The above only is preferred implementation of the present invention; should be pointed out that for those skilled in the art, without departing from the inventive concept of the premise; can also make some improvements and modifications, these improvements and modifications also should be considered within the scope of protection of the present invention.
Claims (10)
1. a thoracic and lumbar vertebral posterior Wicresoft bone cement spinal internal fixation system is characterized in that, is comprised of Wicresoft's bone cement spinal internal fixation system implant and corresponding operating theater instruments.
2. a kind of thoracic and lumbar vertebral posterior as claimed in claim 1 Wicresoft bone cement spinal internal fixation system is characterized in that described Wicresoft bone cement spinal internal fixation system implant comprises pedicle screw, pre-bending pitman and jackscrew.
3. a kind of thoracic and lumbar vertebral posterior as claimed in claim 2 Wicresoft bone cement spinal internal fixation system, it is characterized in that, described pedicle screw is hollow design, simultaneously side, the place ahead perforate or groove, hole or groove quantity can be for a plurality of, and the size of side perforate or groove is less close to more from the bone cement injection end; Screw adopts special-purpose injection tool to inject in implantation afterwards, and the bone cement of injection passes pedicle of vertebral arch by the mesopore of pedicle screw, enters vertebral body from pedicle screw the place ahead side opening or groove.
4. a kind of thoracic and lumbar vertebral posterior as claimed in claim 2 Wicresoft bone cement spinal internal fixation system is characterized in that described pre-bending pitman is curved, and an end is tapered to be dwindled gradually, and the other end is provided with and holds the groove of excellent device coupling.
5. a kind of thoracic and lumbar vertebral posterior as claimed in claim 2 Wicresoft bone cement spinal internal fixation system, it is characterized in that, the described jackscrew outside is provided with screw thread, one end is provided with interior plum blossom hole, the other end is provided with pointed projections, for the single step locking device or be two the step locking devices, after rod is put into, thereby be screwed into locking rod.
6. a kind of thoracic and lumbar vertebral posterior as claimed in claim 2 Wicresoft bone cement spinal internal fixation system is characterized in that described pedicle screw and pre-bending pitman have different specification size, chooses according to actual needs use in the art.
7. a kind of thoracic and lumbar vertebral posterior as claimed in claim 1 Wicresoft bone cement spinal internal fixation system, it is characterized in that, described corresponding operating theater instruments comprises implantation and the orthopedic tool that implant is corresponding, except general operation tool, particularly including the specific purpose tool for micro-wound percutaneous operation and bone cement injection.
8. a kind of thoracic and lumbar vertebral posterior as claimed in claim 7 Wicresoft bone cement spinal internal fixation system, it is characterized in that described corresponding operating theater instruments is puncture needle, the puncture needle sleeve pipe, the tip guide pin, spherical guide pin, hollow gag, dilator, hollow boring bit, hollow screw tap, opening screw stretcher, the screw stretcher of remaining silent, the screw mounting seat, the screw mounting guide sleeve, opening screw stretcher sleeve pipe, the stretcher locking wrench, follow closely device on the hollow, bone cement injector, the rod measuring device, hold excellent device, the rod locker, the push rod device, the fascia separator, plug screw is held and is got device, prelum, crow bar, antitorque spanner, final impact wrench.
9. a kind of thoracic and lumbar vertebral posterior as claimed in claim 1 Wicresoft bone cement spinal internal fixation system is characterized in that described Wicresoft bone cement spinal internal fixation system implant and instrument are fully supporting; Gag, open circuit device, screw tap, pedicle screw, upper nail device are hollow design, and the diameter of hollow is identical with guide pin.
10. the application of a thoracic and lumbar vertebral posterior Wicresoft bone cement spinal internal fixation system in spinal applications.
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| Application Number | Priority Date | Filing Date | Title |
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| CN2011102633876A CN102973314A (en) | 2011-09-07 | 2011-09-07 | Thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system and application |
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| CN2011102633876A CN102973314A (en) | 2011-09-07 | 2011-09-07 | Thoracolumbar spine posterior minimally invasive bone cement spine internal fixation system and application |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105708534A (en) * | 2016-01-03 | 2016-06-29 | 邓宇 | Screw cap of posterior minimally invasive screw-rod system for thoracolumbar vertebral fracture |
| CN109124752A (en) * | 2018-09-14 | 2019-01-04 | 创辉医疗器械江苏有限公司 | A kind of vertebral column minimally invasive Cement fixation device assembly |
| CN109528280A (en) * | 2018-12-19 | 2019-03-29 | 中国人民解放军第二军医大学第二附属医院 | A kind of non-displacement device and anti-displacement system for interior fixation |
| CN109938822A (en) * | 2017-12-21 | 2019-06-28 | 上海三友医疗器械股份有限公司 | The installation tool of bone cement screw |
| CN110225717A (en) * | 2016-08-29 | 2019-09-10 | 乐福骨科有限公司 | Minimally invasive surgery system, device and method |
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| CN105708534A (en) * | 2016-01-03 | 2016-06-29 | 邓宇 | Screw cap of posterior minimally invasive screw-rod system for thoracolumbar vertebral fracture |
| CN110225717A (en) * | 2016-08-29 | 2019-09-10 | 乐福骨科有限公司 | Minimally invasive surgery system, device and method |
| CN109938822A (en) * | 2017-12-21 | 2019-06-28 | 上海三友医疗器械股份有限公司 | The installation tool of bone cement screw |
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| CN109528280A (en) * | 2018-12-19 | 2019-03-29 | 中国人民解放军第二军医大学第二附属医院 | A kind of non-displacement device and anti-displacement system for interior fixation |
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Application publication date: 20130320 |